U.S. Rushes to Finish Influenza Pandemic Plan

The Health secretary is leading a drive to boost federal efforts, and funding, to prepare for a global outbreak if avian flu mutates.

WASHINGTON — Even before it can tally the full cost of post-hurricane reconstruction, the Bush administration is seeking congressional support for an expanded government effort to prepare for a worldwide influenza pandemic.

The Department of Health and Human Services is rushing to complete its first comprehensive plan for coping with a possible flu pandemic, and could release the final version as early as this week. It is expected to be accompanied by a request for several billion dollars in new funding, and Congress appears to be willing to cover at least a portion.

Health authorities are particularly concerned about a virulent strain of avian flu in Asia that has killed several dozen people who handled infected birds. There are signs the virus may now be developing the ability, through mutation, to spread from human to human. It is the mutated form that could cause a pandemic.

The administration's pandemic plan is part of a broader effort to accelerate preparations for a potential health disaster. Conservative estimates of fatalities in a flu pandemic number in the millions worldwide, and in the tens of thousands in the United States.

The government has begun contracting with pharmaceutical makers to develop vaccines targeted at new strains of influenza virus. It has started stockpiling millions of doses of antiviral medicines that could limit symptoms and reduce the chances of spreading the virus. President Bush is pressuring other countries to conduct better surveillance for flu outbreaks, share information more readily and commit to aggressive containment measures.

Still, administration officials cautioned that even perfect planning would only lessen the devastation caused by a pandemic, not prevent it.

Bush's preparedness initiative is being directed by Health and Human Services Secretary Mike Leavitt, who said that of all the issues within his purview, including hurricane recovery and bioterrorism, the one that keeps him awake at night is influenza.

"It's a world-changing event when it occurs," Leavitt said in an interview. "It reaches beyond health. It affects economies, cultures, politics and prosperity -- not to mention human life, counted by the millions."

Bush has taken up the cause personally, prodding the United Nations to make a priority of preparing for a pandemic and raising the issue in one-on-one discussions with the presidents of Russia and China and the prime minister of Indonesia, where in many parts of the country avian flu is endemic in poultry.

"We need to take it seriously," Bush said after a recent meeting with President Vladimir V. Putin of Russia. "I talked to Vladimir about avian flu; I talked to other world leaders about the potential outbreak of avian flu. If avian flu were to hit this country, do we have the proper response mechanisms? Does the federal government have the authority necessary to make certain decisions?"

The need to improve preparedness planning in the U.S. was underscored last October when the American company that provided half of the country's flu vaccines announced that it could not provide shots because of contamination in its British factory.

Last week, Leavitt held private briefings with key lawmakers on Capitol Hill to present the administration's case for an expanded preparedness program. The response was almost immediate. Several members issued public statements endorsing a broader campaign, and the Senate on Thursday approved a measure calling for $3.9 billion in new funding.

That's about what it would take to finance some of the bigger-ticket items in the pandemic plan, such as the development, acquisition and stockpiling of enough vaccine to inoculate 20 million Americans and enough antiviral drugs to help protect another 20 million, according to estimates by the Trust for America's Health, an independent policy research and advocacy group based in Washington.

"We need more than just a plan; we need the resources to actually activate it," said Jeffrey Levi, a pandemic specialist at the Trust. "The real test of the plan will be whether it comes with dollars attached."

The current draft of the administration's plan fills several hundred pages. It describes the role of the federal government in coordinating the response to a flu pandemic and outlines steps to be taken at all levels of government before and during an outbreak.

In addition to production and stockpiling of vaccines and antivirals, the plan seeks to conduct research, prepare public education campaigns and develop ways for hospitals to handle large numbers of patients.

Health authorities say one of the biggest challenges would be vaccine development.

Scientists cannot create the best possible vaccine until they know which form of the virus they're fighting. That means public health officials must remain vigilant and ready to isolate the virus once one emerges in a form that can spread among humans rapidly.